Academic journal article European Journal of Psychotraumatology

The Relationship between Organized Violence, Family Violence and Mental Health: Findings from a Community-Based Survey in Muhanga, Southern Rwanda

Academic journal article European Journal of Psychotraumatology

The Relationship between Organized Violence, Family Violence and Mental Health: Findings from a Community-Based Survey in Muhanga, Southern Rwanda

Article excerpt

EJPTEuropean Journal of Psychotraumatology2000-81982000-8066Co-Action Publishing2132910.3402/ejpt.v4i0.21329CLINICAL RESEARCH ARTICLEThe relationship between organized violence, family violence and mental health: findings from a community-based survey in Muhanga, Southern RwandaRiederHeide*ElbertThomasDepartment of Psychology, University of Konstanz, Konstanz, Germany *Correspondence to: Heide Rieder, University of Konstanz, Department of Psychology, DE-78457 Konstanz, Germany, Email:Heide_Rieder@yahoo.de131120132013410.3402/ejpt.v4i0.21329060520131510201317102013© 2013 Heide Rieder and Thomas Elbert2013

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The relationship between organized violence and family violence, and their cumulative effect on mental health in post-conflict regions remains poorly understood.

The aim of the present study was to establish prevalence rates and predictors of family violence in post-conflict Rwanda. And to examine whether higher levels of war-related violence and its socio-economic consequences would result in higher levels of violence within families and whether this would be related to an increase of psychological distress in descendants.

One hundred and eighty-eight parent-child pairs from four sectors of the district Muhanga, Southern Province of Rwanda, were randomly selected for participation in the study. Trained local psychologists administered structured diagnostic interviews. A posttraumatic stress disorder (PTSD) diagnosis was established using the PTSD Symptom Scale Interview (PSS-I) and child maltreatment was assessed by means of the Childhood Trauma Questionnaire (CTQ). Additionally, the Hopkins Symptom Checklist (HSCL-25) assessed symptoms of depression and anxiety in descendants.

Prevalence rates of child abuse and neglect among descendants were below 10%. Ordinal regression analyses revealed that the level of child maltreatment in descendants was predicted by female sex, poverty, loss of the mother, exposure to war and genocide as well as parents' level of PTSD and reported child maltreatment. Poor physical health, exposure to war and genocide, parental PTSD symptoms, and reported childhood trauma were significantly associated with depressive and anxious symptoms, while only exposure to war and genocide and poor physical health predicted the level of PTSD.

The results indicate that cumulative stress such as exposure to organized violence and family violence in Rwandan descendants poses a risk factor for the development of depressive and anxious symptoms. Besides the support for families to cope with stress, awareness-raising initiatives challenging the current discourse of discipline toward children in schools or at home need to be fostered.

Child maltreatmentpsychopathologygenocidedescendantsRwandaintergenerationalcycle of violence

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Substantial evidence suggests an elevated risk for lasting mental health problems in those exposed to war and conflict. Children and adolescents are a particular vulnerable group and may not only be affected by direct exposure to organized violence but also by secondary adverse effects, such as familial economic decline, malnutrition, lack of education or lasting familial conflict (Joshi & O'Donnell,2003; Shaw,2000). Family stressors such as the loss of beloved ones, the absence of, for example, fathers or ruptures in daily routines may disturb their social-emotional and cognitive development at a similar magnitude and partly mediate the relationship between war exposure and mental health (Miller & Rasmussen,2010).

In a context where the majority of a family is affected by organized violence, children may additionally be exposed to an increase of physical violence within the family. …

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